Caffeinated soft drinks reduce bacterial prevalence in voice prosthetic biofilms

Laryngectomized patients use indwelling silicone rubber voice prostheses, placed in a surgically created fistula in between the trachea and the esophagus, for voice and speech rehabilitation. At the esophageal side, these voice prostheses rapidly become colonized by a thick biofilm consisting of a variety of oral and skin bacteria and yeasts, and on average, after 3-4 months a prosthesis has to be replaced. In this study, the influence of caffeinated soft drinks on biofilm formation on silicone rubber voice prostheses has been investigated in a modified Robbins device. Robbins devices were first inoculated with the total cultivable microflora from an explanted voice prosthesis for 3 d, after which the devices were perfused three times daily over a 12 day period with 650 ml of either phosphate buffered saline or carbonated mineral water (controls), caffeinated soft drinks (two types), or a decaffeinated and a sugar-free version of one of the caffeinated soft drinks. At the end of a day, during the experimental period, the devices were filled with growth medium for 30 min. Both caffeinated soft drinks reduced bacterial prevalence in the biofilms to 1-5% of the control, while yeasts thrived in voice prosthetic biofilms exposed to caffeinated soft drinks. Neither the controls, nor the decaffeinated soft drink, nor the sugar-free version of this showed these effects on bacterial prevalence.